Paediatric Surgery (Ukraine). 2026. 2(91): 9-23. doi: 10.15574/PS.2026.2(91).923
Berestovyy H. O.¹, Turskyi O. F.², Martynova Z. S.², Vinnychenko O. E.², Berestovy O. O.^3
1Private Higher Educational Institution “Kyiv Medical University”, Ukraine
²National Pirogov Memorial Estate Museum, Vinnytsia, Ukraine
³Bogomolets National Medical University, Kyiv, Ukraine

For citation: Berestovyy HO, Turskyi OF, Martynova ZS, Vinnychenko OE, Berestovy OO. (2026). Pirogov’s “Ice Anatomy” as a precursor of modern radiological imaging. Paediatric Surgery (Ukraine). 2(91): 9–23. doi: 10.15574/PS.2026.2(91).923.
Article received: Mar 09, 2026. Accepted for publication: Jun 15, 2026.

The article examines the historical evolution of anatomical research and its relationship to contemporary medical imaging. For centuries, attempts by physicians to visualize pathological foci prior to treatment remained subjective and dependent on individual imagination and clinical experience.
Aim – to provide a conceptual and historical justification of M.I. Pirogov’s “Ice Anatomy” as a precursor of modern medical imaging and to demonstrate its relevance for the interpretation of radiological images.
Materials and methods. A retrospective comparative qualitative descriptive-analytical study was conducted. Materials from the permanent exhibition and archives of the National Pirogov Memorial Estate Museum, original and facsimile anatomical atlases, author’s drawings, archival documents, and digital copies of Anatome topographica (1852-1859) were analyzed. Historical anatomical sections were compared with modern computed tomography (CT) and magnetic resonance imaging (MRI) images in axial, coronal, and sagittal planes. Spatial landmarks, organ relationships, section levels, and the detail of anatomical structures were assessed.
Results. A marked morphological and projectional correspondence was identified between serial sections of frozen human bodies prepared by M.I. Pirogov and modern CT and MRI images. Freezing, sequential sectioning in three mutually perpendicular planes, and accurate graphic reproduction preserved the natural spatial relationships of anatomical structures. Comparisons of sections of the head, thoracic and abdominal cavities, extremities, and joints demonstrated the conceptual similarity of Pirogov’s layer-by-layer approach to the principles of modern tomography, multiplanar reconstruction, and three-dimensional visualization. The historical sections reproduced key topographic relationships that remain fundamental to the interpretation of contemporary radiological images.
Conclusions. M.I. Pirogov’s “Ice Anatomy” represents an important methodological precursor of modern medical imaging. Serial representation of anatomical structures in three planes established a principle of spatial clinical-anatomical thinking that remains relevant to CT and MRI interpretation and to the education of radiologists and surgeons
The authors declare no conflict of interest.
Keywords: M.I. Pirogov, ice anatomy, topographic anatomy, computed tomography, magnetic resonance imaging, pathological anatomy.

REFERENCES

1. Bieliaieva OM, Skrypnikova TP, Lysanets YuV. Morokhovets HYu, Slipchenko LB, Efendiieva SM. (2021). Nikolai Ivanovich Pirogov – amicus humani generis Wiadomości Lekarskie. 74(2): 362-366. https://doi.org/10.36740/WLek202102134; PMid:33813501

2. Da Mota Gomes M. (2020). From the wax cast of brain ventricles (1508-1509) by Leonardo da Vinci to air cast ventriculography (1918) by Walter E. Dandy. Rev Neurol (Paris). 176(5): 393-396. https://doi.org/10.1016/j.neurol.2019.11.005; PMid:32169327

3. De Barros N, Rodrigues CJ, de Negri Germano MA, Cerri GG, Elias J Jr. (2001). The value of teaching sectional anatomy to improve CT scan interpretation. Clin Anat. 14(1): 36-41. https://doi.org/10.1002/1098-2353(200101)14:1<36::AID-CA1006>3.0.CO;2-G; PMid:11135396

4. Fominykh TA, Kutia SA, Saenko AG, Zvereva YeYe. (2024). Outstanding anatomist Felix Vicq-d'Azyr (1748-1794). Zh Nevrol Psikhiatr im SS Korsakova. 124(8): 103-107. https://doi.org/10.17116/jnevro2024124081103; PMid:39269303

5. Ganseman Y, Broos P. (2008). Leonardo da Vinci and Andreas Vesalius; the shoulder girdle and the spine, a comparison. Acta Chirurgica Belgica. 108(4): 477-483. https://doi.org/10.1080/00015458.2008.11680270; PMid:18807610

6. Gerrits PO, Veening JG. (2013, May). Leonardo da Vinci's "A Skull Sectioned": Skull and dental formula revisited. Clinical Anatomy. 26(4): 430-435. https://doi.org/10.1002/ca.22060; PMid:22431331

7. Ghosh S, Sharma S, Biswas S, Chakraborty S. (2014, Oct). Adriaan van den Spiegel (1578-1625): anatomist, physician, and botanist. Clin Anat. 27(7): 952-957. https://doi.org/10.1002/ca.22414; PMid:24811238

8. Gulya AJ. (1995). Anatomy of the temporal bone with surgical implications. 3rd ed. Ed.: A. Julianna Gulya, Harold F. Schuknecht. 2nd ed.: 358-359.

9. Hendriks IF. (2022, Nov 28). Nikolay Ivanovich Pirogov and his contribution to medicine in 19th Century Imperial Russia [Internet]. URL: https://hdl.handle.net/1887/3491451.

10. Hendriks IF, Zhuravlev DA, Bovill JG, Boer F, Gaivoronskii IV, Hogendoorn PC et al. (2020). Nikolay Ivanovich Pirogov (1810-1881): Anatomical research to develop surgery. Clinical Anatomy. 33; 5: 714-730. https://doi.org/10.1002/ca.23493; PMid:31581348 PMCid:PMC7317451

11. Hildebrand R. (2005, Dec). Soemmerring's work on the nervous system: a view on brain structure and function from the late eighteenth century. Anat Embryol (Berl). 210(5-6): 337-342. https://doi.org/10.1007/s00429-005-0027-3; PMid:16180021

12. Hofer M. (2005). CT Teaching Manual: A Systematic Approach to CT Reading. Stuttgart-New York: Thieme: 260.

13. Lichterman B. (2008, Mar 29). Ice Anatomy. BMJ. 336(7646): 725. https://doi.org/10.1136/bmj.39372.653981.13; PMCid:PMC2276305

14. Markatos K, Arkoudi K, Androutsos G. (2017, Dec). Juan Valverde de Amusco (1525-1588): an eminent anatomist of the Renaissance or a plagiarist of Vesalius? His work and its impact in Renaissance anatomy. Acta Chir Belg. 117(6): 407-411. https://doi.org/10.1080/00015458.2017.1383734; PMid:28956497

15. Nevmerzhytska NM, Lakhtadyr TV. (2020). Career and life of Bartolomeo Eustachio (the 500th anniversary of the birth). Bulletin of problems biology and medicine. 2(156): 10-13. https://doi.org/10.29254/2077-4214-2020-2-156-10-13

16. O'Connor JPB. (2003). Thomas Willis and the background to Cerebri Anatome. J R Soc Med. 96(3): 139-143. https://doi.org/10.1258/jrsm.96.3.139; PMid:12612118 PMCid:PMC539424

17. Packard FR. (1921). Life and times of Ambroise Paré (1510-1590): with a new translation of his Apology and an account of his journeys in divers places. New York: Paul B. Hoeber: 297.

18. Persaud TVN, Loukas M, Tubbs RS. (2014). A history of human anatomy. 2nd ed. Springfield, Illinois : Charles C Thomas, Publisher, Ltd.

19. Pevsner J. (2019). Leonardo da Vinci's studies of the brain. The Lancet. 393: 1465-1472. https://doi.org/10.1016/S0140-6736(19)30213-2; PMid:31204682

20. Pirogov NI. (1852). Anatome topographica sectionibus per corpus humanum congelatum tripli21. ci directione ductis illustrata. St. Petersburg: Typis Jacobi Trey.

21. Pirogov NI. (1859). Anatome topographica sectionibus per corpus humanum congelatum triplici directione ductis illustrata. Санкт-Петербург: Typis Jacobi Trey. Перше видання. Pars I, II, III, IV.

22. Ponomarenko LO, Stelmakh NA, Pieieva SP ta insh. (2011). Mykola Ivanovych Pyrohov – vydatnyi khirurh, pedahoh i hromadskyi diiach : do 200-richchia vid dnia narodzhennia. Biobibliohr. pokazhch. Nats. akad. ped. nauk Ukrainy, Derzh. nauk.-ped. b-ka Ukrainy im. V.O. Sukhomlynskoho. Uporiad.: Ponomarenko L.O., Stelmakh N.A., Pieieva S.P. Kyiv: Ped. dumka: 124.

23. Project Gutenberg. (2011). Encyclopaedia Britannica. 11th ed. Vol. 12, Slice 8. "Haller, Albrecht" to "Harmonium". URL: https://www.gutenberg.org/ebooks/38454.

24. Schulz RA, Feser M, Morgan K et al. (2021). How CT happened: the early development of medical computed tomography. Phys Med Biol. 66(18): 18TR01. doi: 10.1088/1361-6560/ac1c43.

25. Shevchenko YuL, Kitayev VM. (2010). Pirogov's "Ice Anatomy" – a prototype of modern radiological imaging. Khirurgiia (Mosk). 9:4.

26. Shevchenko YuT, Fomin VS, Danko YuS, Yachmienova ES, Sukhonosov RO. (2023). Revoliutsiinyi pidkhid Vezaliia do anatomii liudyny v «De Humani Corporis Fabrica Libri Septem». Modern problems of science, education and society. Proceedings of the 2nd International scientific and practical conference, Kyiv, Ukraine, 24-26 April 2023. SPC "Sci-conf.com.ua". Kyiv: 232-236. URL: https://repo.knmu.edu.ua/handle/123456789/33236.

27. Toledo-Pereyra LH (ed.). (2005). Vignettes on surgery, history and humanities. Georgetown, TX: Landes Bioscience: 169. https://doi.org/10.1201/9781498713870

28. Turskyi OF, Kovalenko LH, Vinnychenko OE. (2023). M.I. Pyrohov i Natsionalnyi muzei-sadyba M.I. Pyrohova u mizhnarodnomu prostori. Reports of Vinnytsia National Medical University. 27; 3: 30. https://doi.org/10.31393/reports-vnmedical-2023-27(3)-30

29. Vesalius A. (1682). Andreae Vesalii Bruxellensis, Scholae Medicorum Patavinae Professoris, De humani corporis fabrica librorum epitome. Editio hæc posterior, accommodatius et correctius. Witebergae: Typis Zachariae Lehmanni.

30. Wadham J. (2016, Apr). The Philosophy of Perception: Phenomenology and Image Theory, The British Journal of Aesthetics. 56; 2: 206-209. https://doi.org/10.1093/aesthj/ayv011